I’ll never forget nursing Paloma in those first few weeks of life. As an “experienced” nurser, I thought it was going to be smooth and easy. Instead, I found her choking, coughing and pulling off the breast more times than I could count. I was sore. She was hungry. And we were both unhappy.
After meeting with a lactation consultant, I learned that I had a condition called overactive letdown. As the name suggests, overactive letdown is when your breast milk comes out too fast and hard at letdown.
Signs of overactive letdown
With a newborn baby, who is still getting the hang of sucking, swallowing and assimilating his food, an overactive letdown can be frustrating to say the least.
Some signs to look out for:
- Baby choking during feeding
- Baby coughing during or after feeding
- Pulling back at breast or tugging at the breast or nipple
- Squealing, squeaking, or gulping excessively while nursing
- Make clicking sound at breast (this can also be a sign of tongue or lip tie)
- Milk dribbling down side of baby’s mouth
- Crying or resisting the breast
- Excessive gas, hiccuping or spitting up
Sometimes an overactive letdown can come hand-in-hand with having an oversupply of milk. Many moms have this in the first 4-6 weeks postpartum as this is by design to ensure there is enough food for baby. Usually, your baby will help to regulate your supply and the issue resolves itself. However, many moms with overactive letdown can have gassy or even colicky babies, which is upsetting for all. That’s because baby is consuming too much foremilk and not enough hindmilk. Foremilk is the thin, watery, and lactose-rich component of breast milk that is great for hydration and quick energy. Hindmilk is the creamy and fat-rich part of breast milk that provides nourishment, satiety, and contentment.
It’s vital that baby gets a balance of both parts of milk to ensure optimal digestion and assimilation (not to mention a happy baby). Babies who receive too much foremilk suffer with excess gas (think farting, lots of belching, hiccups, etc.), hunger and even colic. That’s because the foremilk can digest too quickly, without the fat of hindmilk to slow it down, resulting in malabsorption and intestinal distress, not to mention frequent feeding (and sore breasts!) since the milk isn’t as satiating.
Whew, so, what’s a mama to do? The good thing is most babies will learn to adapt to their mom’s letdown as they grow and their digestive system’s mature. Having said that, I needed some ways to deal with it during those first few months.
Tips to handle overactive letdown
1. Clamp down
I find that “clamping down” on the areola can help slow down the milk flow and allow baby to drink at a more agreeable pace (or even suckle for comfort). How do you do it? Well, remember the game “Rock, Paper, Scissors”? Use the scissors hand pose and squeeze down hard on your areola. This will slow the flow coming out of your milk ducts. Beware that you might develop finger/hand soreness or cramping, so take breaks now and then.
2. Laid-back nursing
Sometimes called “Biological Nurturing”, a great way to nurse with an overactive letdown is laying down. Let the baby rest on you so you’re facing belly to belly. You can even let the baby root for the breast herself and latch on. Nursing this way works against gravity, therefore slowing the flow of milk into baby’s mouth. It’s also pretty comfortable! Another option is side-lying position, as sometimes excess milk can dribble out of breast and/or side of baby’s mouth easily this way.
3. Pull baby off at letdown
Many babies struggle the most during the actual milk letdown, which usually takes place 30 seconds to a few minutes into nursing. Most moms can feel their milk preparing to come down their milk ducts. A great way to ease baby’s discomfort with an overactive letdown is take him off the breast and catch the forceful milk in a towel, burp cloth or breast milk bag. Once letdown is complete, re-latch baby and let him nurse. If you want to save the milk from the other breast that’s released during letdown (each drop is so valuable!), check out this product. If you are tandem nursing, you can have toddler drink for the first minute or two during the letdown, and then pop baby back on breast.
4. Use a pacifier (very judiciously)
Wha wha what?! Mama Natural is recommending a pacifier? Well, yes. For moms with an overactive letdown, it can be a wonderful tool. Babies are born with a strong reflux to suck. In some feeding situations, babies get to suckle both breasts for about 30 minutes total per feeding. Whereas with me and my overactive letdown, feeding sessions lasted about five minutes on just one boob before Paloma got all the milk she needed. Not fair for her, really. If your baby is content, no worries. But, when it’s the witching hour and baby wants to suckle for comfort but is overwhelmed by the milk flow, you could try a pacifier. (This is a good one for newborns.) You can also try using a very clean finger for baby to suck on as an alternative.
5. Block feedings
If you’re dealing with oversupply issues too, you may want to offer just one breast per feeding. For mom’s with severe oversupply issues, you can even offer that same breast for the next feeding and then offer the second breast. That way you can be sure baby will get all of the good hind milk, and it will be a more pleasant nursing experience, since the milk letdown won’t be as rapid as the breast empties. This will also help to regulate your overall milk production, since you’re not stimulating both breasts at each feeding. Be sure to work with a lactation consultant to decide if Block Feeding is right for you.
6. Get help
There are so many great resources out there if you continue to struggle with feedings. I always recommend a check up with a lactation consultant (and have done so myself with both of my kids.) They are worth their weight in GOLD and give you hands-on help with overactive letdown issues or, and even more importantly, diagnose any issues that may be preventing your child from latching and drinking your milk well like a tongue or lip tie. You can search for a local lactation consultant here.
Additionally, consider attending a local La Leche or Breastfeeding USA meeting. These organizations are led by nursing mamas or even breastfeeding counselors and are filled with other nursing moms just like you. You bet you’ll find another mama who has dealt with an overactive letdown and can share her experience with you. One of the greatest things about these meetings is that they are FREE! You can find local meetings on their websites.
Know that it gets better…
Bottom line, don’t give up. Breastfeeding does get easier for baby and for mama. As your baby grows, she’ll be able to drink up and enjoy your overactive letdown (it’s true!). In the interim though, try the above-mentioned tips to get you through those uncomfortable first weeks or months as you both are adjusting.
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Would love to hear from YOU
Have you tried anything that works with reducing milk supply or slowed a fast letdown? Share with us so we can learn from each other!